Australian Blood Donation Policy is Out of Step with International Reforms

In Australia and around the globe, the COVID-19 pandemic has reduced people’s opportunity to donate blood. Lockdowns, social distancing measures, and the broader uncertainty caused by COVID-19 have at times resulted in around 900 cancellations of blood donation appointments each day, resulting in a sharp decrease in the levels of blood supply for the requirement of blood transfusions in Australia. Despite this, Australian blood donation policy preserves unnecessary population-based barriers that restrict donations from men who have sex with men (MSM). This approach remains out of step with recent international developments regarding blood donation policy that focus on an individualised risk assessment, such as those implemented in the UK earlier this year.

In June 2021, the United Kingdom recently amended their blood donation policy reversing previous policies rendering all men who had sexual contact with another man in the past three months ineligible to donate blood, replacing this with an individualised risk assessment approach. This new approach requires all individuals seeking to donate blood to be asked about their recent sexual activities, rather than asking if they are a man who has had sex with another man.

In essence, under these new regulations men who have only had sexual contact with one male partner in the last three months are still eligible to donate blood, reflecting a lower risk profile of monogamous gay couples.

This approach is closely aligned with recent German reforms. The German Medical Association announced in mid-2021 reforms to blood donation policy that allow MSM who are in a monogamous relationship to donate blood four months after their last sexual contact with a new partner. Previously, German regulations mandated that MSM were required to wait 12 months until after their last sexual contact in order to donate blood.

Despite recent commendable reforms that have decreased previous timeframes of requiring MSM to wait 12 months since their last sexual contact, Australian reforms still remain out of step with their UK and German counterparts, current regulations mandating Australian MSM to abstain from sex for a period of three months in order to be eligible to donate blood.

However, individuals who take PrEP (Pre-Exposure HIV Prophylaxis) are prohibited from donating blood until 12 months after their last dose, on the basis that PrEP impacts the ability of tests to detect HIV. These blanket rules, which operate without a consideration of individual risk profile, unnecessarily stigmatise MSM. This is particularly so in circumstances where all donations are tested for HIV, with RNA tests that can detect HIV 11 days after transmission.

In this regard, Australia’s current regulation is inadequately responding to the scarcity of blood donations for those who desperately need transfusions. The adoption of reforms similar to those in the UK and Germany would go some way toward redressing Australian blood supply shortages, particularly in the wake of COVID-19, and further allow for a more equitable, non-discriminatory manner for MSM to donate blood.